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Vaccine Safety

Kim Goodman's first child, grant, screamed all night after getting the measles-mumps-rubella (MMR) vaccine. Then her second child, Jack, had the rotavirus immunization -- which was later recalled because it was thought to cause bowel obstruction in some cases. Now Goodman is wary about giving the new pneumococcal vaccine to her third child, 2-month-old James. "My husband and I aren't nearly as trusting this time around," she says. "I'm nervous about all these shots, though I do understand their importance -- my dad had polio."

The Goodmans aren't alone in their unease about the growing number of baby shots doctors recommend. (With the addition last year of the pneumococcal vaccine, a child gets 23 doses of seven different vaccines before age 6 -- a single well-baby visit may now include as many as five shots.) In one national survey, one in four parents said they believe that too many vaccines can weaken a child's immune system. In a poll of pediatricians and family physicians, three out of four said that at least one parent had refused to allow a child to be immunized in the past year. Fueling fears are stories about possible links between vaccines and autism, brain damage, and juvenile diabetes.

"We're seeing a crisis of trust," says Barbara Loe Fisher, president of the National Vaccine Information Center, a vaccine-safety advocacy group. "For too long, doctors have simply dismissed parents' worries, saying, 'You have to immunize or you're a bad parent.'"

For all the anxiety, U.S. immunization rates remain high. In 2000, 76 percent of children between 19 and 35 months old were fully immunized, down 2 percent from the previous year. But even a small falloff concerns public-health experts. "Any drop in immunization rates only increases the chance of potentially deadly outbreaks of vaccine-preventable diseases," says Paul Offit, M.D., chief of infectious diseases at the Children's Hospital of Philadelphia and coauthor of Vaccines: What Every Parent Should Know. In Colorado, researchers analyzed health records from 1987 to 1998 and found that unvaccinated children were 22 times more likely to get measles and 6 times more likely to get whooping cough. Since no vaccine is 100 percent effective, kids who've been immunized are also vulnerable: Even when there's a very slight drop in vaccination rates, immunized children suffer a higher incidence of these infectious diseases.

The good news: Recent studies have examined the major concerns raised about vaccines, with reassuring results. At the same time, new steps have been taken to make vaccines safer and to identify the tiny subset of children -- fewer than 1 in 10,000 -- who may be at risk of a significant reaction.

Contributing editor Jessica Snyder Sachs's most recent book is titled Corpse: Nature, Forensics, and the Struggle to Pinpoint Time of Death.